1407053606 NPI number — CARDONA PAIN & ANESTHESIA

Table of content: RUTH MORRISON M.S., OTR/L (NPI 1689088551)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407053606 NPI number — CARDONA PAIN & ANESTHESIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDONA PAIN & ANESTHESIA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407053606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1757 SW CABIN PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34990-4213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-624-0702
Provider Business Mailing Address Fax Number:
561-624-0773

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-2788
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-624-0702
Provider Business Practice Location Address Fax Number:
561-624-0773
Provider Enumeration Date:
06/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DURAN
Authorized Official First Name:
ROBERTO
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
561-624-0702

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  ME84122 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11542195 . This is a "CAQH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1407053606 . This is a "ORGANIZATION NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1619915964 . This is a "NPI PERONAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: AH762 . This is a "MEDICARE PTAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: ME84122 . This is a "MEDICAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com